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Mercogliano M, Valdecantos RL, Fevola G, Sorrentino M, Buonocore G, Triassi M, Palladino R. An ecological analysis of socio-economic determinants associated with paediatric vaccination coverage in the Campania Region: A population-based study, years 2003-2017. Vaccine X 2024; 18:100482. [PMID: 38585381 PMCID: PMC10997839 DOI: 10.1016/j.jvacx.2024.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Vaccines are the most cost-effective and straightforward intervention against severe infectious diseases. However, in Europe and in Italy, paediatric vaccination coverage for certain vaccines remains suboptimal, with considerable regional differences in Italy. Vaccine coverage varies significantly due to socio-economic and organisational factors. Aim of this study was to assess the influence of the Deprivation Index, the density of General Practitioners and General Paediatricians per inhabitants on the coverage of both mandatory and non-mandatory paediatric vaccinations across local health authorities and health districts in the Campania Region for birth cohorts from 2001 to 2015. Materials and methods Population-based, ecological time series analysis focusing on the Campania Region, most populous region in the south of Italy. Vaccination coverage data were extracted from the regional immunization database, whilst information on the Deprivation Index and number of primary care doctors and primary care paediatricians per local health district were extracted from public health records. Univariate descriptive statistics were employed to describe study characteristics, as appropriate, whilst and mixed-effect linear regression models were employed to assess the associations between variables of interest and vaccination coverage. Results Overall vaccination coverage has generally increased, except for the MMR vaccine, which showed coverage fluctuations. An increase in the Deprivation Index, indicative of less favourable socio-economic conditions, was associated with decreased vaccination coverage in the 24-month age group for some mandatory vaccines (DTaP: Coef -0.97, 95% CI -1.77 | -0.17; Poliomyelitis: Coef -0.98, 95% CI -1.78 | -0.17; Hepatitis B: Coef -0.90, 95% CI -1.71 | -0.10). Moreover, areas with a greater density of General Paediatricians per inhabitants saw increased coverage for Haemophilus influenzae type b in the 6-year age group (Coef 9.78, 95% CI 1.00 | 18.56). Conclusions It is necessary to target public health policies to address vaccination inequalities. These efforts should include expanding vaccination campaigns, enhancing catch-up programs, and increase resource allocation in primary care settings to facilitate the role of General Practitioners and Paediatricians in fostering awareness and adherence.
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Affiliation(s)
| | | | - Gianluca Fevola
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Gaetano Buonocore
- Clinical Directorate, University Hospital “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131 Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131 Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK
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Essa-Hadad J, Gorelik Y, Vervoort J, Jansen D, Edelstein M. Understanding the health system barriers and enablers to childhood MMR and HPV vaccination among disadvantaged, minority or underserved populations in middle- and high-income countries: a systematic review. Eur J Public Health 2024; 34:368-374. [PMID: 38183166 PMCID: PMC10990506 DOI: 10.1093/eurpub/ckad232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Child vaccinations are among the most effective public health interventions. However, wide gaps in child vaccination remain among different groups with uptake in most minorities or ethnic communities in Europe substantially lower compared to the general population. A systematic review was conducted to understand health system barriers and enablers to measles, mumps and rubella (MMR) and human papilloma virus (HPV) child vaccination among disadvantaged, minority populations in middle- and high-income countries. METHODS We searched Medline, Cochrane, CINAHL, ProQuest and EMBASE for articles published from 2010 to 2021. Following title and abstract screening, full texts were assessed for relevance. Study quality was appraised using Critical Appraisal Skills Program checklists. Data extraction and analysis were performed. Health system barriers and enablers to vaccination were mapped to the World Health Organization health system building blocks. RESULTS A total of 1658 search results were identified from five databases and 24 from reference lists. After removing duplicates, 1556 titles were screened and 496 were eligible. Eighty-six full texts were assessed for eligibility, 28 articles met all inclusion criteria. Factors that affected MMR and HPV vaccination among disadvantaged populations included service delivery (limited time, geographic distance, lack of culturally appropriate translated materials, difficulties navigating healthcare system), healthcare workforce (language and poor communication skills), financial costs and feelings of discrimination. CONCLUSION Policymakers must consider health system barriers to vaccination faced by disadvantaged, minority populations while recognizing specific cultural contexts of each population. To ensure maximum policy impact, approaches to encourage vaccinations should be tailored to the unique population's needs. A one-size-fits-all approach is not effective.
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Affiliation(s)
- Jumanah Essa-Hadad
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Yanay Gorelik
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Johanna Vervoort
- Department of Health Sciences-Global Health Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Danielle Jansen
- Department of Primary- and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michael Edelstein
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
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Abdirakhman T, Balay-Odao EM, Aljofan M, Cruz JP. Highly Educated Mother's Perception of Childhood Vaccination Hesitancy in Kazakhstan: A Thematic Analysis. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2024; 12:86-97. [PMID: 38650958 PMCID: PMC11032417 DOI: 10.30476/ijcbnm.2024.100940.2393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/15/2024] [Accepted: 03/10/2024] [Indexed: 04/25/2024]
Abstract
Background Vaccine hesitancy among parents directly affects the child's vaccination status since they are the legal decision-makers regarding vaccinating their children. The study aimed to describe the perceptions of highly educated Kazakhstani mothers about childhood vaccination hesitancy. Methods The study utilized a thematic analysis to explore the mothers' perceptions. A sample of 95 participants comprehensively answered the free-text questions in an online questionnaire from January to February 2023. The analysis of the free-text responses followed a semantic thematic analysis approach. The data were coded manually. Results From the in-depth analysis of the data, 285 initial codes were extracted. The combination of similar meanings and concept codes led to 14 sub-themes and finally yielded four significant themes: misconceptions about childhood vaccination, fear of the effect of vaccine on children, distrust of the healthcare system, and social learning factors. Conclusion The perceptions of Kazakh mothers about childhood vaccination hesitancy may lead to behaviors of delaying and refusing some or all childhood vaccines. Therefore, motivational and educational strategies can be used by healthcare providers to instill trust in parents about childhood vaccines and their safety and effectiveness.
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Affiliation(s)
- Togzhan Abdirakhman
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | | | - Mohamad Aljofan
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Jonas Preposi Cruz
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
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Haidar S, Richard E, Vaux S, Allaire C, Castor C, Levy Bruhl D, Mondeilh A, Vandentorren S. Factors associated with vaccine adherence among an underserved population: the adult Travellers in Nouvelle-Aquitaine, France. Eur J Public Health 2024; 34:163-169. [PMID: 38031445 PMCID: PMC10843962 DOI: 10.1093/eurpub/ckad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND A measles epidemic affected the Nouvelle-Aquitaine region from November 2017 to May 2018 with clusters among Travellers. This indicates that measles vaccination rates among Travellers remain lower than in the general population. The objective of this study was to estimate the 'declarative vaccination' against measles, mumps and rubella (MMR) and to propose a conceptual framework to help identify determinants of MMR vaccination uptake among adult Travellers in Nouvelle-Aquitaine in 2019-20. METHODS A cross-sectional study using random sampling was performed and included 612 adult Travellers from 1 November 2019 to 31 March 2020. A conceptual framework to model vaccination adherence was tested among this underserved population by using structural equation modelling. This model included five latent variables: health literacy, attitudes toward preventive measures, stigma, accessibility to care and perceived needs and five measured variables: information received on vaccination, perception of barriers, support for administrative documents, social support and housing conditions. RESULTS Individuals who did not answer all the questions linked to the variables included in the model were excluded, thus 347 adults were included in the final sample. The declared vaccination rate against MMR was 74.0%, and 72.4% of the participants were favorable to vaccination. Vaccination adherence was significantly correlated with favorable attitudes toward preventive measures such as having a history of MMR vaccination and not having already refused a recommended vaccine and finally satisfactory information received on vaccination. DISCUSSION To improve vaccination adherence, health authorities should lean on personal history with vaccination and on transmitting information on vaccination.
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Affiliation(s)
- Sahar Haidar
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Elodie Richard
- Bordeaux Population Health Laboratory, Inserm U1219, University of Bordeaux, Bordeaux, France
| | - Sophie Vaux
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Cecile Allaire
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Christine Castor
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Daniel Levy Bruhl
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Aude Mondeilh
- Fédération Nationale des Associations Solidaires d’Action avec les Tsiganes et les Gens du Voyage (FNASAT—Gens du Voyage), Paris, France
| | - Stéphanie Vandentorren
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
- Bordeaux Population Health Laboratory, Inserm U1219, University of Bordeaux, Bordeaux, France
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Mondeilh A, Brabant G, Haidar S, Saboni L, Ruello M, Lesieur S, Castor C, Autes-Treand E, Le strat Y, Vandentorren S. Health status, healthcare use and child MMR vaccination coverage in Travellers according to their environmental and living conditions in Nouvelle-Aquitaine, France, 2019-2022. Eur J Public Health 2023; 33:1194-1199. [PMID: 37889591 PMCID: PMC10710340 DOI: 10.1093/eurpub/ckad175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The poor health status of underserved populations is compounded by low vaccination uptake, leading to a greater risk of epidemics. On October 2017, a measles outbreak started in the southwest of France among under-vaccinated social groups, including Travellers. We aimed to describe the health status, healthcare use and child measles-mumps-rubella (MMR) vaccination coverage in Travellers according to their environmental and living conditions. METHODS A cross-sectional study with a three-stage random sample design was conducted between October 2019 and March 2022 in the Nouvelle-Aquitaine region in France. Trained social workers administered face-to-face questionnaires to collect data on adults and children. Anthropometric measurements, vaccination records and data using an environmental exposure questionnaire were also collected. RESULTS The participation rate was high (73.6%), with 1030 adults and 337 children included. Concerning the adults, 36.6% had obesity, 14.4% reported diabetes, 24.7% hypertension and 14.4% major depression. The prevalence of major depression was significantly higher in adults living in precarious and unauthorized housing than in those with adequate housing (19.8 vs. 14.7%, P = 0.03). With regard to children, 45.3% had full (i.e. 2-dose) MMR vaccination coverage at 24 months and 17.9% had obesity. Finally, 74.5% of the households experienced housing insecurity, and 22.2% did not have a supply of drinking water. CONCLUSION Traveller children and adults faced deleterious environmental and living conditions potentially affecting their health, healthcare use and vaccination coverage. These results demonstrate the need for urgent interventions for underserved populations which take into account their specific needs.
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Affiliation(s)
- Aude Mondeilh
- Fédération nationale des associations solidaires d’action avec les tsiganes et les Gens du voyage (FNASAT – Gv), Paris, France
- Bordeaux Population Health, Université de Bordeaux, PHAReS, Centre Inserm U1219, Bordeaux, France
| | - Gilles Brabant
- Fédération nationale des associations solidaires d’action avec les tsiganes et les Gens du voyage (FNASAT – Gv), Paris, France
| | | | | | - Marc Ruello
- Santé publique France, Saint Maurice, France
| | - Sophie Lesieur
- Institut Pierre Louis d’épidémiologie et de santé publique (IPLESP), Sorbonne Université, Equipe de recherche en épidémiologie sociale, Inserm, Paris, France
| | - Christine Castor
- Santé publique France, Direction des régions, Cellule Nouvelle-Aquitaine – Bordeaux – France
| | | | | | - Stéphanie Vandentorren
- Bordeaux Population Health, Université de Bordeaux, PHAReS, Centre Inserm U1219, Bordeaux, France
- Santé publique France, Saint Maurice, France
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Filakovska Bobakova D, Plavnicka J, Urbancikova I, Edelstein M, Jansen D, Dankulincova Veselska Z. Barriers to HPV vaccination in marginalized Roma communities in Slovakia. Front Public Health 2023; 11:1239963. [PMID: 38115851 PMCID: PMC10728715 DOI: 10.3389/fpubh.2023.1239963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Limited access to healthcare services leads to lower vaccination rates in marginalized Roma communities (MRCs). This study aimed to explore health system barriers to HPV vaccination faced by people from MRCs from multiple perspectives. Methods The qualitative study was conducted in Slovakia in 2021/22 with 43 community members and health professionals. Data were analyzed using a combination of content analysis and consensual qualitative research. Results A substantial barrier to vaccination is limited coverage of vaccination expenses for certain age categories by health insurance. Moreover, Slovakia faces a significant shortage of healthcare personnel, leading to work overload and a lack of capacity and motivation to address HPV vaccination. Impaired relationships between health care providers and people from MRCs lead to the avoidance of healthcare services, which contributes to insufficient delivery of information and a lack of awareness regarding HPV-related diseases and vaccination. Conclusion Strengthening the capacities of health care providers, expanding the age group covered by health insurance and providing tailored information to people from MRCs are necessary prerequisites to increase the availability of HPV vaccination and enable people to make informed decisions about HPV vaccination.
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Affiliation(s)
- Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia
| | - Jana Plavnicka
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Ingrid Urbancikova
- Department of Epidemiology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | | | - Danielle Jansen
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Zuzana Dankulincova Veselska
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
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Ménétrey A, Landolt MA, Buettcher M, Neuhaus TJ, Simma L. Vaccine Hesitancy in Central Switzerland: Identifying and Characterizing Undervaccinated Children in a Pediatric Emergency Department. Pediatr Rep 2023; 15:710-721. [PMID: 38133432 PMCID: PMC10747840 DOI: 10.3390/pediatric15040064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Vaccinations play an important role in the prevention of potentially fatal diseases. Vaccine hesitancy has become an important problem both in the public discourse and for public health. We aimed to identify and characterize this potentially unvaccinated or incompletely vaccinated group of children presenting to the pediatric emergency department (PED) of the tertiary children's hospital in central Switzerland, a region that has anecdotally been claimed as a hotspot for vaccine hesitancy. All patients presenting to the PED (N = 20,247) between September 2018 and September 2019 were screened for their vaccination status and categorized as incomplete, unvaccinated, or fully vaccinated in a retrospective cohort study. Some 2.6% (n = 526) visits to the PED were not or incompletely vaccinated according to age, or their vaccination status was unknown. Most of the children in the cohort were not critically ill, and the minority had to be hospitalized. Undervaccinated patients were overrepresented in rural areas. Of all cohort visits, 18 (3.4%) patients received opportunistic vaccination in the PED. No cases of vaccine-preventable diseases were observed. In summary, incompletely vaccinated and unvaccinated status was less frequent than initially expected. The PED may play a role in increasing vaccination coverage by providing opportunistic vaccinations.
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Affiliation(s)
- Anika Ménétrey
- Department of Pediatrics, Children’s Hospital Lucerne, Spitalstrasse, 6000 Lucerne, Switzerland
- Department of Neurology, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Markus A. Landolt
- Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, 8032 Zurich, Switzerland
- Children’s Research Center, University Children’s Hospital of Zurich, University of Zurich, 8032 Zurich, Switzerland
| | - Michael Buettcher
- Pediatric Infectious Diseases Unit, Children’s Hospital Lucerne, Cantonal Hospital Lucerne, 6000 Lucerne, Switzerland;
- Department of Pediatric Pharmacology and Pharmacometrics, University Children’s Hospital Basel, University of Basel, 4056 Basel, Switzerland
| | - Thomas J. Neuhaus
- Department of Pediatrics, Children’s Hospital Lucerne, Spitalstrasse, 6000 Lucerne, Switzerland
| | - Leopold Simma
- Children’s Research Center, University Children’s Hospital of Zurich, University of Zurich, 8032 Zurich, Switzerland
- Emergency Department, University Children’s Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
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Herzig van Wees S, Abunnaja K, Mounier-Jack S. Understanding and explaining the link between anthroposophy and vaccine hesitancy: a systematic review. BMC Public Health 2023; 23:2238. [PMID: 37957574 PMCID: PMC10644591 DOI: 10.1186/s12889-023-17081-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Due to low vaccination uptake and measles outbreaks across Europe, public health authorities have paid increasing attention to anthroposophic communities. Public media outlets have further described these communities as vaccine refusers or "anti-vaxxers". The aim of this review was to understand the scope of the problem and explore assumptions about vaccination beliefs in anthroposophic communities. For the purpose of this review, we define anthroposophic communities as people following some/certain views more or less loosely connected to the philosophies of anthroposophy. The systematic review addresses three research questions and (1) collates evidence documenting outbreaks linked to anthroposophic communities, (2) literature on vaccination coverage in anthroposophic communities, and (3) lastly describes literature that summarizes theories and factors influencing vaccine decision-making in anthroposophic communities. METHODS This is a systematic review using the following databases: Medline, Web of Science, Psycinfo, and CINAHL. Double-blinded article screening was conducted by two researchers. Data was summarized to address the research questions. For the qualitative research question the data was analysed using thematic analysis with the assistance of Nvivo12.0. RESULTS There were 12 articles documenting 18 measles outbreaks linked to anthroposophic communities between the years 2000 and 2012. Seven articles describe lower vaccination uptake in anthroposophic communities than in other communities, although one article describes that vaccination coverage in low-income communities with a migrant background was lower than in the anthroposophic community they studied. We found eight articles examining factors and theories influencing vaccine decision making in anthroposophic communities. The qualitative analysis revealed four common themes. Firstly, there was a very broad spectrum of vaccine beliefs among the anthroposophic communities. Secondly, there was a consistent narrative about problems or concerns with vaccines, including toxicity and lack of trust in the system. Thirdly, there was a strong notion of the importance of making individual and well-informed choices as opposed to simply following the masses. Lastly, making vaccine choices different from public health guidelines was highly stigmatized by those outside of the anthroposophic community but also those within the community. CONCLUSION Continuing to further knowledge of vaccine beliefs in anthroposophic communities is particularly important in view of increasing measles rates and potential sudden reliance on vaccines for emerging diseases. However, popular assumptions about vaccine beliefs in anthroposophic communities are challenged by the data presented in this systematic review.
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Affiliation(s)
| | - Khadija Abunnaja
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Sandra Mounier-Jack
- Department of Global Health and Development, London School of Hygiene and Tropical, London, UK
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Jacobson A, Spitzer S, Gorelik Y, Edelstein M. Barriers and enablers to vaccination in the ultra-orthodox Jewish population: a systematic review. Front Public Health 2023; 11:1244368. [PMID: 37900036 PMCID: PMC10602685 DOI: 10.3389/fpubh.2023.1244368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Background The Jewish Ultra-Orthodox (UO) population is an under-vaccinated minority group that has been disproportionally affected by outbreaks of vaccine-preventable diseases (VPD) such as measles and polio. Underlying reasons remain poorly characterized. We aimed to identify vaccination barriers and enablers in this population. Methods We systematically reviewed the literature (PROSPERO: CRD42021273001), searching Pub-med, Web of science, Medline, PsychNet and Scopus from 1995 to 2021 for quantitative and qualitative primary research in English. Studies published outside the date range, not including barriers or enablers, or that were non-primary research were excluded. We assessed included publications for quality and extracted relevant data based on the 5As taxonomy: access, awareness, affordability, acceptance and activation. Results We included nine qualitative and seven quantitative studies from the 125 studies identified. Access barriers included scheduling difficulties, inconvenient opening hours, and logistical difficulties related to having multiple young children. Acceptance barriers included safety concerns. Insufficient knowledge about the importance of vaccine and timely vaccination and the perception of being shielded from infections because of seclusion from wider society were key awareness barriers. Competing priorities, such as work and housework, were the main affordability barriers. Mainstream religious leadership's support for vaccination was an enabler, although recent studies suggest their influence on vaccination behavior is decreasing and influence of anti-vaccination messages is growing. Discussion Barriers to vaccination among the UO were mainly logistical, with little religious framing. Safety and efficacy concerns were similar to those reported in the wider community. Decreasing influence of the traditionally pro-vaccine mainstream religious leadership and growing influence of anti-vaccination movements targeting the UO community are new phenomena that require close monitoring. Tailored interventions are required to protect the community and wider society against future VPD outbreaks. Systematic review registration PROSPERO: CRD42021273001.
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10
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Carlson SJ, Attwell K, Roberts L, Hughes C, Blyth CC. West Australian parents' views on vaccinating their children against COVID-19: a qualitative study. BMC Public Health 2023; 23:1764. [PMID: 37697268 PMCID: PMC10494404 DOI: 10.1186/s12889-023-16645-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 08/29/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Australian children and adolescents were among the last local cohorts offered COVID-19 vaccines. Despite promising initial uptake, coverage subsequently plateaued, requiring further efforts to improve access and build parents' recognition of the importance of COVID-19 vaccination. We sought to understand West Australian (WA) parents' willingness to vaccinate their children to inform strategies for improving uptake at the time in which they were becoming eligible. METHODS We undertook in-depth qualitative interviews with 30 parents of children aged 5-17 years from June - December 2021. During this period, children aged 12-15 years became eligible for vaccination; children aged 5-11 years became eligible shortly thereafter. Data were thematically analysed in NVivo. RESULTS Most parents intended on vaccinating their children once eligible. Parents sought to protect their children, to protect the community, to resume travel, and to get back to "normal". They reflected that vaccination against key infectious threats is a routine activity in childhood. Some were concerned about the vaccine, particularly mRNA vaccines, being new technology or impacting fertility. "Wait-awhiles" wanted to see what other parents would do or were delaying until they felt that there was a higher risk of COVID-19 in WA. Most parents of younger children wanted their child to be vaccinated at the general practice clinic due to familiarity and convenience. Parents were particularly eager for clear and consistent messaging about vaccination of children and adolescents, including safety, importance, scientific evidence, and personal stories. CONCLUSION For future pandemic vaccinations pertaining to children, governments and health officials need to address parents' concerns and meet their preferences for the delivery of the vaccine program to children and adolescents.
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Affiliation(s)
- Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- School of Social Sciences, The University of Western Australia, Perth, WA, Australia
| | - Katie Attwell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- School of Social Sciences, The University of Western Australia, Perth, WA, Australia
| | - Leah Roberts
- School of Social Sciences, The University of Western Australia, Perth, WA, Australia
| | | | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia.
- School of Medicine, University of Western Australia, Perth, WA, Australia.
- Department of Infectious Diseases, Perth Children's Hospital, Perth, WA, Australia.
- Department of Microbiology, PathWestLaboratory Medicine, Perth, WA, Australia.
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11
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Fasce A, Schmid P, Holford DL, Bates L, Gurevych I, Lewandowsky S. A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling. Nat Hum Behav 2023; 7:1462-1480. [PMID: 37460761 DOI: 10.1038/s41562-023-01644-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/25/2023] [Indexed: 09/23/2023]
Abstract
The proliferation of anti-vaccination arguments is a threat to the success of many immunization programmes. Effective rebuttal of contrarian arguments requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitude roots-that is, the underlying psychological attributes driving a person's belief-of opposition to vaccines. Here, through a pre-registered systematic literature review of 152 scientific articles and thematic analysis of anti-vaccination arguments, we developed a hierarchical taxonomy that relates common arguments and themes to 11 attitude roots that explain why an individual might express opposition to vaccination. We further validated our taxonomy on coronavirus disease 2019 anti-vaccination misinformation, through a combination of human coding and machine learning using natural language processing algorithms. Overall, the taxonomy serves as a theoretical framework to link expressed opposition of vaccines to their underlying psychological processes. This enables future work to develop targeted rebuttals and other interventions that address the underlying motives of anti-vaccination arguments.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn L Holford
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Essex, Colchester, UK
| | - Luke Bates
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Iryna Gurevych
- Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
- Department of Psychology, University of Potsdam, Potsdam, Germany
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12
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Machado-Alba JE, Machado-Duque ME, Vargas-Zambrano JC. High coverage and timeliness of vaccination of children under 6 years of age in Risaralda, Colombia. Hum Vaccin Immunother 2023; 19:2257424. [PMID: 37722884 PMCID: PMC10512904 DOI: 10.1080/21645515.2023.2257424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023] Open
Abstract
This study determined the coverage and timeliness of immunization in children <6 y from Risaralda, Colombia. A retrospective cross-sectional study evaluated data from a vaccination coverage and timeliness verification survey conducted in 2019, including 2457 children <6 y from Risaralda, Colombia. Variables included demographics, a record of vaccinations included in the Colombian Vaccination Plan, and date of immunization. Vaccination was defined as timely until 29 d after the day established by the plan. Coverage was over 95% for all vaccinations, except the boosters of diphtheria/pertussis/tetanus (DTP) and oral polio at 18 months (91.0%), influenza (85.6%), and yellow fever (49.2%). Most surveyed children demonstrated very high timeliness of vaccination, with values close to, or over, 90%, although there were exceptions for pentavalent (DTP+Haemophilus influenzae type B+hepatitis B) and polio vaccines at 6 months (79.4%), influenza (85.6%), and yellow fever (49.2%). Before the COVID-19 pandemic, Colombian Vaccination Plan demonstrated high coverage and timeliness of vaccination of children <6 y of age; however, timeliness for the third dose of DTP-Hib-HBV and polio showed opportunities for improvement.
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Affiliation(s)
- Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA, Pereira, Colombia
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA, Pereira, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
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13
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Raciborski F, Tomaszewska A, Rakocy K, Samel-Kowalik P, Samoliński B, Gujski M, Pinkas J, Jankowski M. The multidimensional nature of attitudes towards preventive vaccinations - a cross-sectional survey among Poles aged 15-39 years. Int J Occup Med Environ Health 2023; 36:214-228. [PMID: 37184146 PMCID: PMC10464729 DOI: 10.13075/ijomeh.1896.02068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVES Vaccination skepticism and vaccination refusal both constitute global public health concerns. Systematic monitoring of public attitudes towards vaccination is crucial for maintaining a high vaccination coverage rate. The study aimed to identify and characterize homogenous social groups distinguished by attitudes toward preventive vaccinations. MATERIAL AND METHODS Between October and November of 2021, a nationwide representative cross-sectional survey was conducted on a representative sample of 1560 inhabitants of Poland aged 15-39 years. The study questionnaire included 60 questions on public attitudes towards vaccines, vaccination, and the COVID-19 pandemic. Factor analysis was applied to identify the main dimensions of vaccination attitudes. RESULTS Factor analysis included 22 variables and yielded 3 factors or dimensions that accounted for 48.5% of the model's variability. Young adults were assigned into 6 homogeneous groups based on these factors: 1) general trust in vaccination, 2) vaccine safety concerns, 3) trust in fake medical news regarding COVID-19 vaccination, and denying the COVID-19 pandemic. Groups I-IV differed by sociodemographic factors and vaccination coverage rates. Nearly 60% of the respondents expressed concern regarding various aspects of vaccination. CONCLUSIONS Most of Poland's young adults lack clearly defined attitudes towards vaccination. Attitudes towards vaccination can be divided into 6 heterogeneous groups. Int J Occup Med Environ Health. 2023;36(2):214-28.
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Affiliation(s)
- Filip Raciborski
- Medical University of Warsaw, Warsaw, Poland (Department of Prevention of Environmental Hazards, Allergology and Immunology)
| | - Aneta Tomaszewska
- Medical University of Warsaw, Warsaw, Poland (Department of Prevention of Environmental Hazards, Allergology and Immunology)
| | | | - Piotr Samel-Kowalik
- Medical University of Warsaw, Warsaw, Poland (Department of Prevention of Environmental Hazards, Allergology and Immunology)
| | - Bolesław Samoliński
- Medical University of Warsaw, Warsaw, Poland (Department of Prevention of Environmental Hazards, Allergology and Immunology)
| | - Mariusz Gujski
- Medical University of Warsaw, Warsaw, Poland (Department of Public Health)
| | - Jarosław Pinkas
- Center of Postgraduate Medical Education, Warsaw, Poland (School of Public Health)
| | - Mateusz Jankowski
- Center of Postgraduate Medical Education, Warsaw, Poland (School of Public Health)
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14
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Toshkov D. What accounts for the variation in COVID-19 vaccine hesitancy in Eastern, Southern and Western Europe? Vaccine 2023; 41:3178-3188. [PMID: 37059674 PMCID: PMC10070781 DOI: 10.1016/j.vaccine.2023.03.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 04/16/2023]
Abstract
In the wake of mass COVID-19 vaccination campaigns in 2021, significant differences in vaccine skepticism emerged across Europe, with Eastern European countries in particular facing very high levels of vaccine hesitancy and refusal. This study investigates the determinants of COVID-19 vaccine hesitancy and refusal, with a focus on these differences across Eastern, Southern and Western Europe. The statistical analyses are based on individual-level survey data comprising quota-based representative samples from 27 European countries from May 2021. The study finds that demographic variables have complex associations with vaccine hesitancy and refusal. The relationships with age and education are non-linear. Trust in different sources of health-related information has significant associations as well, with people who trust the Internet, social networks and 'people around' in particular being much more likely to express vaccine skepticism. Beliefs in the safety and effectiveness of vaccines have large predictive power. Importantly, this study shows that the associations of demographic, belief-related and other individual-level factors with vaccine hesitancy and refusal are context-specific. Yet, explanations of the differences in vaccine hesitancy across Eastern, Southern and Eastern Europe need to focus on why levels of trust and vaccine-relevant beliefs differ across regions, because the effects of these variables appear to be similar. It is the much higher prevalence of factors such as distrust of national governments and medical processionals as sources of relevant medical information in Eastern Europe that are relevant for explaining the higher levels of vaccine skepticism observed in that region.
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Affiliation(s)
- Dimiter Toshkov
- Institute of Public Administration, Leiden University, the Netherlands
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15
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Ayorinde A, Ghosh I, Ali I, Zahair I, Olarewaju O, Singh M, Meehan E, Anjorin SS, Rotheram S, Barr B, McCarthy N, Oyebode O. Health inequalities in infectious diseases: a systematic overview of reviews. BMJ Open 2023; 13:e067429. [PMID: 37015800 PMCID: PMC10083762 DOI: 10.1136/bmjopen-2022-067429] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities. METHODS We searched MEDLINE, Embase, Web of Science and OpenGrey databases in November 2021. We included reviews published from the year 2000 which examined inequalities in the incidence, prevalence or consequences of infectious diseases based on the dimensions of interest. Our search focused on tuberculosis, HIV, sexually transmitted infections, hepatitis C, vaccination and antimicrobial resistance. However, we also included eligible reviews of any other infectious diseases. We appraised the quality of reviews using the Assessment of Multiple Systematic Reviews V.2 (AMSTAR2) checklist. We conducted a narrative data synthesis. RESULTS We included 108 reviews in our synthesis covering all the dimensions of inequalities for most of the infectious disease topics of interest, however the quality and volume of review evidence and consistency of their findings varied. The existing literature reviews provide strong evidence that people in inclusion health groups and lower socioeconomic status are consistently at higher risk of infectious diseases, antimicrobial resistance and incomplete/delayed vaccination. In the protected characteristics dimension, ethnicity, and sexual orientation are important factors contributing to inequalities across the various infectious disease topics included in this overview of reviews. CONCLUSION We identified many reviews that provide evidence of various types of health inequalities in different infectious diseases, vaccination, and antimicrobial resistance. We also highlight areas where reviews may be lacking. The commonalities in the associations and their directions suggest it might be worth targeting interventions for some high risk-groups that may have benefits across multiple infectious disease outcomes rather than operating purely in infectious disease siloes.
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Affiliation(s)
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Ifra Ali
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Iram Zahair
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Olajumoke Olarewaju
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megha Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Edward Meehan
- School of Public Health and Prevention Medicine, Monash University, Clayton, Victoria, Australia
| | | | - Suzanne Rotheram
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Ben Barr
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Noel McCarthy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Queen Mary University of London, London, London, UK
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16
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Kavalidou K, Daly C, McTernan N, Corcoran P. Presentations of self-harm and suicide-related ideation among the Irish Traveller indigenous population to hospital emergency departments: evidence from the National Clinical Programme for self-harm. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02439-7. [PMID: 36797373 DOI: 10.1007/s00127-023-02439-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE Previous research has examined the suicide risk of the Irish Traveller population, but less is known about self-harm and suicidal ideation among this ethnic minority group, which are established risk factors for suicide. The aim of the current study was to compare the presentation-based self-harm and suicide-related ideation of Traveller to non-Traveller patients and describe any ethnic disparities in the aftercare of their presentation. METHODS Data were obtained from the service improvement database of an Irish dedicated national programme for the assessment of those presenting to emergency departments (EDs) due to self-harm and suicide-related ideation. Presentation data from 24 EDs were analysed and Poisson regression was used to assess the age-sex-adjusted relative risk of hospital-presenting self-harm and suicide-related ideation. RESULTS 24,473 presentations were recorded with 3% of the presentations made by Irish Travellers. Female Traveller patients had 3·04 (95% CI 2·51-3·68) higher risk for suicide-related ideation and 3·85 (95% CI 3·37-4·41) for self-harm, compared to white Irish female patients. Male Traveller patients had 4·46 (95% CI 3·86-5·16) higher risk for suicide-related ideation and 5·43 (95% CI 4·75-6·21) higher rates for self-harm. The highest rate ratios for self-harm were observed among older Traveller patients [male: 9·23 (95% CI 5·93-14·39); female: 6·79 (95% CI 4·37-10·57)]. A higher proportion of Traveller patients requested no next of kin involvement, compared to other ethnicities. CONCLUSIONS Given that Irish Travellers are at higher risk of self-harm and suicide-related ideation presentations compared to other ethnic groups, EDs should be viewed as an important suicide intervention point.
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Affiliation(s)
- Katerina Kavalidou
- National Clinical Programme for Self-Harm and Suicide-Related Ideation, HSE, Dr Steevens' Hospital, Dublin 8, Dublin, D08 W2A8, Ireland.
- National Suicide Research Foundation, University College Cork, Cork, Ireland.
| | - Caroline Daly
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Niall McTernan
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Paul Corcoran
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
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17
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National Disparities in Antibiotic Prescribing by Race, Ethnicity, Age Group, and Sex in United States Ambulatory Care Visits, 2009 to 2016. Antibiotics (Basel) 2022; 12:antibiotics12010051. [PMID: 36671252 PMCID: PMC9854843 DOI: 10.3390/antibiotics12010051] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
While efforts have been made in the United States (US) to optimize antimicrobial use, few studies have explored antibiotic prescribing disparities that may drive future interventions. The objective of this study was to evaluate disparities in antibiotic prescribing among US ambulatory care visits by patient subgroups. This was a retrospective, cross-sectional study utilizing the National Ambulatory Medical Care Survey from 2009 to 2016. Antibiotic use was described as antibiotic visits per 1000 total patient visits. The appropriateness of antibiotic prescribing was determined by ICD-9 or ICD-10 codes assigned during the visit. Subgroup analyses were conducted by patient race, ethnicity, age group, and sex. Over 7.0 billion patient visits were included; 11.3% included an antibiotic prescription. Overall and inappropriate antibiotic prescription rates were highest in Black (122.2 and 78.0 per 1000) and Hispanic patients (138.6 and 79.8 per 1000). Additionally, overall antibiotic prescription rates were highest in patients less than 18 years (169.6 per 1000) and female patients (114.1 per 1000), while inappropriate antibiotic prescription rates were highest in patients 18 to 64 years (66.0 per 1000) and in males (64.8 per 1000). In this nationally representative study, antibiotic prescribing disparities were found by patient race, ethnicity, age group, and sex.
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18
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Dahan S, Bloemhof‐Bris E, Weizman S, Pesah M, Gorno N, Abu Shah M, Levi G, Shelef A. Factors affecting the willingness of mental health staff to get vaccinated against COVID-19. J Eval Clin Pract 2022; 28:948-957. [PMID: 35731528 PMCID: PMC9349556 DOI: 10.1111/jep.13722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/23/2022]
Abstract
RATIONALE AND OBJECTIVE At the beginning of vaccination against coronavirus disease 2019 (COVID-19), information about the effects of the vaccine was not known and hesitancy was observed among the population. The mental health staff members in our center in Israel had to decide whether to get vaccinated or not. The objective of this study was to evaluate the differences in demographic characteristics of vaccinated and nonvaccinated mental health care workers (HCWs), and to identify their reasons for or against vaccination. METHOD Data on characteristics of 357 staff members at a mental health center (MHCS) in Israel and their attitudes regarding COVID-19 vaccination, those who were nonvaccinated, were collected via anonymous questionnaires, from 1 January to 10 January 2021. The groups were then compared using χ2 , Fisher's exact tests, t test or Mann-Whitney nonparametric test as appropriate. A logistic regression was then performed using the significant variables and odd ratios presented. RESULTS Eighty-one per cent of the sample received at least the first dose of the vaccine. Results indicated differences in seniority (p < 0.001), profession (p < 0.001), department (p < 0.001), risk groups (p < 0.05), religion (p < 0.001), religiosity (p < 0.001), previous care for COVID-19 patients (p < 0.05) and level of interaction with patients (p < 0.01), between the vaccinated and nonvaccinated staff. The factor that was found to be most influential regarding vaccination and which convinced those originally against the vaccine to become vaccinated was the level of scientific knowledge about the vaccine. CONCLUSION Efforts and resources should focus on the dissemination of reliable scientific data about the vaccine, to increase vaccination rates among mental HCWs.
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Affiliation(s)
- Sagit Dahan
- Lev‐Hasharon Mental Health CenterZur MosheIsrael
- Department of Psychiatry, Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - Esther Bloemhof‐Bris
- Lev‐Hasharon Mental Health CenterZur MosheIsrael
- Dual Diagnosis DepartmentAbarbanel Mental Health CenterBat YamIsrael
| | - Shira Weizman
- Department of Psychiatry, Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
- Dual Diagnosis DepartmentAbarbanel Mental Health CenterBat YamIsrael
| | - Moran Pesah
- Lev‐Hasharon Mental Health CenterZur MosheIsrael
| | - Nadav Gorno
- Lev‐Hasharon Mental Health CenterZur MosheIsrael
- Department of Psychiatry, Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | | | - Galit Levi
- Lev‐Hasharon Mental Health CenterZur MosheIsrael
| | - Assaf Shelef
- Lev‐Hasharon Mental Health CenterZur MosheIsrael
- Department of Psychiatry, Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
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19
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Wróblewski M, Meler A, Stankowska J, Kawiak-Jawor E. An Analysis of Factors Shaping Vaccine Attitudes and Behaviours in a Low-Trust Society Based on Structural Equation Modelling-The Case of Poland's Vaccination Programme against COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14655. [PMID: 36429367 PMCID: PMC9690255 DOI: 10.3390/ijerph192214655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
This study focuses on factors that shape vaccine attitudes and behaviours in the context of a low-trust society. Our analysis focuses on the Polish vaccination programme against COVID-19, primarily on (1) the evaluation of the information campaign, (2) trust in the institutions, (3) trust in other people, (4) attitudes toward vaccine safety and efficacy, (5) attitudes toward restrictions related to vaccination (e.g., restricted access to certain services for unvaccinated persons) and the introduction of mandatory vaccination, (6) the evaluation of the government's actions during the pandemic, and (7) political preferences. The study was conducted with a sample of 1143 adult residents in Poland (CATI). The explanation of the factors determining the COVID-19 vaccine was based on structural equation modelling (SEM). The model showed that the declared fact of vaccination was largely determined by a positive attitude toward restrictions related to vaccination and trust in vaccines. The formation of the provaccine attitude was to an extent determined by the assessment of the government's campaign and actions during pandemic. While institutional trust had a positive effect on support for the ruling coalition (0.56), the latter on its own had the opposite effect (-0.61) on the formation of provaccine attitude. In the group who both trust institutions and support the parties currently in power, there are more of those who simultaneously reject the restrictions and mandatory vaccination and remain sceptical about the safety and efficacy of COVID-19 vaccines than those who both trust in the vaccine safety and efficacy and accept the restrictions and mandatory vaccination. This indicates that in the context of strong political polarisation, ideological affiliations may play a greater role in shaping vaccine attitudes and behaviours than institutional trust.
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Affiliation(s)
- Michał Wróblewski
- Institute of Sociology, Nicolaus Copernicus University, 87-100 Toruń, Poland
- The Łukasiewicz Research Network Institute of Organisation and Management in Industry, 00-879 Warszawa, Poland
| | - Andrzej Meler
- Institute of Sociology, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Joanna Stankowska
- Institute of Sociology, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Ewa Kawiak-Jawor
- The Łukasiewicz Research Network Institute of Organisation and Management in Industry, 00-879 Warszawa, Poland
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20
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Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, Jenner L, Petit A, Lewandowsky S, Vanderslott S, Innocenti S, Larkin M, Giubilini A, Yu LM, McShane H, Pollard AJ, Lambe S. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med 2022; 52:3127-3141. [PMID: 33305716 PMCID: PMC7804077 DOI: 10.1017/s0033291720005188] [Citation(s) in RCA: 399] [Impact Index Per Article: 199.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. METHODS A non-probability online survey was conducted (24th September-17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. RESULTS 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: 'excessive mistrust' (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and 'positive healthcare experiences' (r=-0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. CONCLUSIONS COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S. Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Andrew Chadwick
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Cristian Vaccari
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Laina Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Lucy Jenner
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Ariane Petit
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Stefania Innocenti
- Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK
| | - Michael Larkin
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK
| | - Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Helen McShane
- Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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21
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Freeman D, Loe BS, Chadwick A, Vaccari C, Waite F, Rosebrock L, Jenner L, Petit A, Lewandowsky S, Vanderslott S, Innocenti S, Larkin M, Giubilini A, Yu LM, McShane H, Pollard AJ, Lambe S. COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med 2022. [PMID: 33305716 DOI: 10.1017/s0033291720001890,1-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
BACKGROUND Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. METHODS A non-probability online survey was conducted (24th September-17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. RESULTS 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: 'excessive mistrust' (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and 'positive healthcare experiences' (r=-0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. CONCLUSIONS COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Andrew Chadwick
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Cristian Vaccari
- Online Civic Culture Centre, Department of Communication and Media, Loughborough University, Loughborough, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Laina Rosebrock
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Lucy Jenner
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Ariane Petit
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Samantha Vanderslott
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Stefania Innocenti
- Smith School of Enterprise and the Environment, University of Oxford, Oxford, UK
| | - Michael Larkin
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK
| | - Alberto Giubilini
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Helen McShane
- Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Sinéad Lambe
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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22
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Efficacy of Naproxen/Fexofenadine (SJP-003) in the Prevention of Side Effects of Influenza Vaccination: Four Case Studies. Clin Pract 2022; 12:734-737. [PMID: 36136870 PMCID: PMC9498481 DOI: 10.3390/clinpract12050076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/02/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
The influenza virus is associated with sickness, and in particular among vulnerable populations such as elderly and those with underlying disease with hospitalization and increased mortality rates. Vaccination is an effective way to prevent infection with influenza. However, undesirable side effects of the vaccination are commonly experienced, and comprise one of the primary reasons for a substantial group of individuals to refrain from vaccination. An effective treatment against vaccination side effects could increase the overall willingness to vaccinate against influenza. Here, four cases are presented that self-administered SJP-003 (a combination of 220 mg naproxen sodium, directly followed by a single oral dose of 60 mg fexofenadine HCL), 2 h before and 10 h after influenza vaccination. No flu-like symptoms and pain at the injection site were reported. These observations warrant further investigation of SJP-003 in double-blind, placebo-controlled clinical trials.
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Cronin A, Ibrahim N. A scoping review of literature exploring factors affecting vaccine uptake within Roma communities across Europe. Expert Rev Vaccines 2022; 21:1429-1442. [PMID: 35877604 DOI: 10.1080/14760584.2022.2104715] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Vaccine hesitancy is described by the WHO as one of the top threats to global health. The trajectory of the current COVID-19 pandemic depends upon the vaccination of a global population; therefore, barriers to routine vaccination within marginalized groups considered vaccine hesitant are of critical importance. Consistently, vaccination levels within Roma communities across Europe rate very poorly in comparison with general population coverage, and a number of measles and hepatitis outbreaks over the past 10 years have included Roma communities. This study aims to identify barriers to Roma vaccination in general with a view to informing analysis of potential low levels of vaccination within Roma communities for COVID-19. AREAS COVERED The research question explores factors and barriers affecting general vaccine (non-COVID-19 vaccine) uptake within Roma communities across Europe. This scoping review was conducted using the Arksey & O'Malley framework, complying with PRISMA-SR for Scoping Review guidelines. EXPERT OPINION Using Thomson's 5A's Taxonomy, access was identified as the greatest barrier to vaccination within Roma communities. Access factors had the greatest number of references in this scoping review and were considered the most relevant in terms of increasing vaccination uptake. Important access themes identified are health system issues, socioeconomic conditions, and mobility.
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Affiliation(s)
- Anne Cronin
- School of Medicine (Public Health), University of Limerick, Limerick, Ireland
| | - Nuha Ibrahim
- School of Medicine (Public Health), University of Limerick, Limerick, Ireland
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24
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de Munter AC, Hautvast JL, Ruijs WL, Henri Spaan D, Hulscher ME, Ruiter RA. Deciding about maternal pertussis vaccination: associations between intention, and needs and values in a vaccine-hesitant religious group. Vaccine 2022; 40:5213-5222. [DOI: 10.1016/j.vaccine.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 07/02/2022] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
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25
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Burger MN, Mayer M, Steimanis I. Repeated information of benefits reduces COVID-19 vaccination hesitancy: Experimental evidence from Germany. PLoS One 2022; 17:e0270666. [PMID: 35763537 PMCID: PMC9239477 DOI: 10.1371/journal.pone.0270666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Many countries, such as Germany, struggle to vaccinate enough people against COVID-19 despite the availability of safe and efficient vaccines. With new variants emerging and the need for booster vaccinations, overcoming vaccination hesitancy gains importance. The research to date has revealed some promising, albeit contentious, interventions to increase vaccination intention. However, these have yet to be tested for their effectiveness in increasing vaccination rates. Methods & results We conducted a preregistered survey experiment with N = 1,324 participants in Germany in May/June 2021. This was followed by a series of emails reminding participants to get vaccinated in August and concluded with a follow-up survey in September. We experimentally assess whether debunking vaccination myths, highlighting the benefits of being vaccinated, or sending vaccination reminders decreases hesitancy. In the survey experiment, we find no increase in the intention to vaccinate regardless of the information provided. However, communicating vaccination benefits over several weeks reduced the likelihood of not being vaccinated by 9 percentage points, which translates into a 27% reduction compared to the control group. Debunking vaccination myths and reminders alone also decreased the likelihood, yet not significantly. Discussion Our findings suggest that if soft governmental interventions such as information campaigns are employed, highlighting benefits should be given preference over debunking vaccination myths. Furthermore, it seems that repeated messages affect vaccination action while one-time messages might be insufficient, even for increasing vaccination intentions. Our study highlights the importance of testing interventions outside of survey experiments that are limited to measuring vaccination intentions—not actions—and immediate changes in attitudes and intentions—not long-term changes.
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Affiliation(s)
| | - Matthias Mayer
- Department of Economics, Philipps University Marburg, Marburg, Germany
| | - Ivo Steimanis
- Department of Economics, Philipps University Marburg, Marburg, Germany
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26
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Wongnuch P, Mulikaburt T, Apidechkul T, Srichan P, Tamornpark R, Udplong A, Suratana S, Kitchanapaibul S. Acceptance and accessibility to the early phase COVID-19 vaccination among the healthcare workers and hill tribe population in Thailand. Sci Rep 2022; 12:11035. [PMID: 35773315 PMCID: PMC9244445 DOI: 10.1038/s41598-022-15149-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a serious emerging disease and an extreme threat to human life. This study aimed to understand the perceptions of hill tribe people living in the border areas of Thailand-Myanmar and health workers regarding the acceptability and accessibility of the COVID-19 vaccine and health workers’ perceptions of the readiness to implement the vaccination program during the early period of national COVID-19 vaccination. A qualitative method was applied to elicit information from key informants who lived in hill tribe villages and the health professionals who served them. The study was conducted in seven hill tribe villages located along the Thailand-Myanmar borders in Mae Fah Luang District, Chiang Rai Province, Thailand. The participants were hill tribe villagers aged 20 years and over; public health care professionals working in village health centers who had primary roles in implementing disease prevention and control measures; and public health care professionals working in districts and provincial public health offices who had primary roles in policy development and implementation. A total of 63 participants (26 men and 37 women) from seven hill tribe villages provided information. Three acceptance choices regarding receiving the COVID-19 vaccine were found among the hill tribes: definite acceptance, likely acceptance, and no preference. Two factors related to obtaining access to the new COVID-19 vaccine were found: Thai citizenship and the level of literacy related to the vaccine. There was no process or protocol in place for implementing the new vaccine among health professionals working at the district, subdistrict, or community levels, but the national expanded immunization program (EPI) system was clearly demonstrated to extend throughout the health service chain in Thailand. During the early period of national COVID-19 vaccine implantation in Thailand, not all members of the hill tribes accepted the vaccine; participant acceptance depended on several factors, including a participant’s previous experience with vaccination, whether he or she required more information before making a decision, etc. While acceptance of the vaccine depended on the individual’s background, not everyone had an equal opportunity to access the vaccine. The new COVID-19 vaccine should be available at the village level, including in hill tribe villages, to reduce the systemic threat to the country.
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Affiliation(s)
- Pilasinee Wongnuch
- School of Health Sciences, Mae Fah Luang University, Chiang Rai, Thailand.,Center of Excellence for Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand
| | | | - Tawatchai Apidechkul
- School of Health Sciences, Mae Fah Luang University, Chiang Rai, Thailand. .,Center of Excellence for Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand.
| | - Peeradone Srichan
- School of Health Sciences, Mae Fah Luang University, Chiang Rai, Thailand.,Center of Excellence for Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand
| | | | - Anusorn Udplong
- School of Health Sciences, Mae Fah Luang University, Chiang Rai, Thailand
| | - Soontaree Suratana
- School of Health Sciences, Mae Fah Luang University, Chiang Rai, Thailand
| | - Siwarak Kitchanapaibul
- School of Health Sciences, Mae Fah Luang University, Chiang Rai, Thailand.,Center of Excellence for Hill Tribe Health Research, Mae Fah Luang University, Chiang Rai, Thailand
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27
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Holz M, Mayerl J, Andersen H, Maskow B. How Does Migration Background Affect COVID-19 Vaccination Intentions? A Complex Relationship Between General Attitudes, Religiosity, Acculturation and Fears of Infection. Front Public Health 2022; 10:854146. [PMID: 35462811 PMCID: PMC9019123 DOI: 10.3389/fpubh.2022.854146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of the study is to investigate the relationship between migration background and COVID-19 vaccine intentions, exploring multiple mediation paths. We argue that the migrational and sociocultural background influences general attitudes toward health and political/public institutions. The effects of these general attitudes on vaccination intentions are mediated by fears of infection. Additionally, we analyze a migrant-only model including acculturation variables (years since migration, foreign and host country media consumption) and region of origin (European vs. Non-European). Design: The data (n = 1027) stem from an online access panel collected between March 15 and March 25, 2021. Quotas for gender and age were set according the online population of Germany. The use of an oversampling framework for first generation migrants resulted in a sample with 50% first generation migrants and 50% native Germans without migration background. Models were calculated using a Structural Equation Modeling approach. Results Migration background both increases and decreases antecedents of vaccination intentions. Being a migrant increases positive antecedents like religiosity, which in turn positively influence general attitudes and thus fears of infection and vaccination intentions. But being a migrant has also a significant direct negative association with vaccination intentions, implying missing mediators. Increasing years since migration increase host country (German) media consumption and decrease consumption of media from the country of origin. Both media variables are positively associated with political trust and health consciousness. Additionally, European compared to Non-European migrants have less political trust, fear of personal infection and lower vaccination intentions on the whole. Conclusions The study found that vaccination intentions can be understood by applying the proposed hypothetical structure. We found complex associations of the migration and sociocultural background and COVID-19 vaccination intentions, where antecedents of vaccination intentions are both increased and decreased by migration background and migration specific factors.
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Affiliation(s)
- Manuel Holz
- Chemnitz University of Technology, Chemnitz, Germany
| | - Jochen Mayerl
- Chemnitz University of Technology, Chemnitz, Germany
| | | | - Britta Maskow
- Chemnitz University of Technology, Chemnitz, Germany
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28
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Abstract
Objectives To describe the evolution of the national vaccination programme in Norway and how changes in national policy informed by risk and equity shaped international vaccine debates, public trust and vaccine hesitancy. Methods Documentary analysis of publicly available statistics, government documents and media sources. Results Process equity founded on social solidarity was central to the approach taken to vaccination in Norway but within the context of a very low level of COVID-19 Infection. Conclusions In the context of Norway with very low levels of infection, the risks associated with vaccine side effects were of a similar order to the risk of infection which led to an early decision to exclude the AstraZeneca vaccine and limit access to the Janssen vaccine. Public trust in the way the state managed the changes in the vaccination programme resulted in very limited public resistance to the vaccine programme, high levels of vaccine uptake and an acceptance of delays associated with the exclusion of two approved vaccines. Vaccination rates among Norwegian residents born in Eastern Europe were significantly lower than both foreign born and Norwegian born residents.
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29
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Fadda M, Camerini AL, Fiordelli M, Corna L, Levati S, Amati R, Piumatti G, Crivelli L, Suggs LS, Albanese E. Why Vaccinate Against COVID-19? A Population-Based Survey in Switzerland. Int J Public Health 2022; 67:1604226. [PMID: 35418817 PMCID: PMC8997237 DOI: 10.3389/ijph.2022.1604226] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 02/24/2022] [Indexed: 12/28/2022] Open
Abstract
Objectives: This study examined factors associated with COVID-19 vaccination intention at the very beginning of the vaccination campaign in a representative sample of the population in southern Switzerland.Methods: In March 2021, we measured vaccination intention, beliefs, attitudes, and trust in a sample of the Corona Immunitas Ticino study.Results: Of the 2681 participants, 1933 completed the questionnaire (response rate = 72%; 55% female; meanage = 41, SD = 24, rangeage = 5–91). Overall, 68% reported an intention to get vaccinated. Vaccination intention was higher in social/healthcare workers, and increased with age, trust in public health institutions, and confidence in the vaccine efficacy. Prior infection of a family member, predilection for waiting for more evidence on the safety and efficacy of the vaccine, and for alternative protective means were negatively associated with intention.Conclusion: In view of needs of COVID-19 vaccine boosters and of suboptimal vaccination coverage, our results have relevant public health implications and suggest that communication about vaccine safety and efficacy, and aims of vaccination programs, should be bi-directional, proportionate, and tailored to the concerns, expectations, and beliefs of different population subgroups.
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Affiliation(s)
- Marta Fadda
- Institute of Public Health, University of Italian Switzerland, Lugano, Switzerland
- *Correspondence: Marta Fadda,
| | - Anne Linda Camerini
- Institute of Public Health, University of Italian Switzerland, Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, University of Italian Switzerland, Lugano, Switzerland
| | - Laurie Corna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Sara Levati
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Rebecca Amati
- Institute of Public Health, University of Italian Switzerland, Lugano, Switzerland
| | - Giovanni Piumatti
- Institute of Public Health, University of Italian Switzerland, Lugano, Switzerland
- Unit of Development and Research in Medical Education, Université de Genève, Geneva, Switzerland
| | - Luca Crivelli
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - L. Suzanne Suggs
- Institute of Public Health, University of Italian Switzerland, Lugano, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, University of Italian Switzerland, Lugano, Switzerland
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30
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Lindeman M, Svedholm-Häkkinen AM, Riekki TJJ. Searching for the cognitive basis of anti-vaccination attitudes. THINKING & REASONING 2022. [DOI: 10.1080/13546783.2022.2046158] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Marjaana Lindeman
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Annika M. Svedholm-Häkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Tampere Institute for Advanced Study, Tampere University, Tampere, Finland
- Faculty of Education and Culture, Tampere University, Tampere, Finland
| | - Tapani J. J. Riekki
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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31
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Jarab AS, Al-Qerem W, Mukattash TL. Community pharmacists' willingness and barriers to provide vaccination during COVID-19 pandemic in Jordan. Hum Vaccin Immunother 2022; 18:2016009. [PMID: 35050841 PMCID: PMC8986174 DOI: 10.1080/21645515.2021.2016009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 11/26/2022] Open
Abstract
Providing vaccination in community pharmacies could increase the vaccination coverage rate as well as help reducing the workload of the healthcare system. The current study was conducted to evaluate community pharmacists' willingness and barriers to provide vaccination in community pharmacy setting. A validated questionnaire which included eight items to evaluate willingness and eleven items to evaluate the barriers to provide vaccines was distributed online. Binary logistic regression was conducted to explore the factors that are significantly associated with willingness and barriers to provide the vaccine. Among the 201 participating pharmacists, 174 (86.6%) had a high willingness level. Lack of authorization (91.6%), lack of collaboration with other healthcare professionals (85.6%), and lack of space for storage (74.1%) were the most recognized barriers to vaccinate. Pharmacists with BSc degree demonstrated less willingness (OR = 0.18 (0.07-0.46), and increased barriers (OR = 4.86 (1.56-15.17) to provide the vaccine when compared with Pharm D and postgraduate pharmacists P < .01. Factors including male gender (OR: 6.10), working in chain pharmacy (OR: 8.98) and rural areas (OR: 4.31), moderate income (OR: 19.34) and less years of experience (OR:0.85) were significantly associated with increased barriers to provide the vaccine (P < .05). Despite the high willingness of the community pharmacists to vaccinate, several barriers were present. Enhancing pharmacists' authorization and collaboration with other healthcare professionals and providing space for storage along with providing training courses and workshops should be considered to enhance pharmacist's engagement in vaccination service.
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Affiliation(s)
- Anan S. Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Tareq L. Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake. Vaccines (Basel) 2021; 10:vaccines10010007. [PMID: 35062668 PMCID: PMC8777721 DOI: 10.3390/vaccines10010007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a return to pre-pandemic ways of living. However, vaccine development, distribution and promotion have not been sufficient to ensure maximum vaccine uptake. Vaccination is an individual choice and requires acceptance of the need to be vaccinated in light of any risks. This paper presents a behavioural sciences framework to promote vaccine acceptance by addressing the complex and ever evolving landscape of COVID-19. Effective promotion of vaccine uptake requires understanding the context-specific barriers to acceptance. We present the AACTT framework (Action, Actor, Context, Target, Time) to identify the action needed to be taken, the person needed to act, the context for the action, as well as the target of the action within a timeframe. Once identified a model for identifying and overcoming barriers, called COM-B (Capability, Opportunity and Motivation lead to Behaviour), is presented. This analysis identifies issues associated with capability, opportunity and motivation to act. These frameworks can be used to facilitate action that is fluid and involves policy makers, organisational leaders as well as citizens and families.
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Recio-Román A, Recio-Menéndez M, Román-González MV. Vaccine Hesitancy and Political Populism. An Invariant Cross-European Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412953. [PMID: 34948573 PMCID: PMC8701982 DOI: 10.3390/ijerph182412953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022]
Abstract
Vaccine-hesitancy and political populism are positively associated across Europe: those countries in which their citizens present higher populist attitudes are those that also have higher vaccine-hesitancy rates. The same key driver fuels them: distrust in institutions, elites, and experts. The reluctance of citizens to be vaccinated fits perfectly in populist political agendas because is a source of instability that has a distinctive characteristic known as the “small pockets” issue. It means that the level at which immunization coverage needs to be maintained to be effective is so high that a small number of vaccine-hesitants have enormous adverse effects on herd immunity and epidemic spread. In pandemic and post-pandemic scenarios, vaccine-hesitancy could be used by populists as one of the most effective tools for generating distrust. This research presents an invariant measurement model applied to 27 EU + UK countries (27,524 participants) that segments the different behaviours found, and gives social-marketing recommendations for coping with the vaccine-hesitancy problem when used for generating distrust.
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Issues surrounding incentives and penalties for COVID-19 vaccination: The Israeli experience. Prev Med 2021; 153:106763. [PMID: 34352308 PMCID: PMC8327565 DOI: 10.1016/j.ypmed.2021.106763] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/02/2022]
Abstract
The purpose of this study was to examine patterns of COVID-19 vaccination in Israel and how these relate to different proposals made about benefits for those vaccinated, and to present the legal and ethical dilemmas surrounding these issues. A retrospective study of COVID-19 vaccination rates in Israel was conducted, with data obtained from the Ministry of Health (MOH). Information on benefits proposed or offered for vaccination and restrictions for non-vaccination were obtained from the MOH and presented in a timeline. By March 1st, 51% of the total population, and 91% of those aged 60 and over, had received their first COVID-19 vaccine. Exemption from quarantine was granted to vaccinated or recovered people from 17th January 2021. The 'green pass' incentive scheme, granting access to social, cultural and sporting events for those fully vaccinated or immune, was proposed in December 2020, and came into effect on February 21st 2021. Incentive schemes which impose limitations on those who choose not to vaccinate may motivate some people to take action. Policymakers should use a measured approach to protect public health, with minimum infringement on citizens' rights. Providing transparent and culturally appropriate information on immunization and ensuring maximal and equitable access to COVID-19 vaccines may help build trust.
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35
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Attitude, Familiarity and Religious Beliefs about Vaccination among Health Science and Non-Health Science Students in a Malaysian Public University. Eur J Investig Health Psychol Educ 2021; 11:1462-1473. [PMID: 34842641 PMCID: PMC8628736 DOI: 10.3390/ejihpe11040104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 12/03/2022] Open
Abstract
Vaccine hesitancy has surfaced globally within the last few decades, and the fears and misconceptions of people about vaccine safety and effectiveness have been identified as key factors for their under-utilization. The familiarity, attitudes, and religious beliefs of the public and of future healthcare practitioners regarding vaccination are extensive areas needing exploration. The present exploratory cross-sectional study was designed, planned and carried out on students enrolled in health science and non-health science courses in one of the public universities of Malaysia. A research instrument that had been formulated, validated and subjected to reliability testing was used to collect the data, which were analyzed using descriptive and inferential statistics. A response rate of 80.8% (n = 202) was obtained: the majority were female (n = 161, 79.7%), and had been vaccinated before (n = 190, 97.5%), while a mere 2% did not support vaccination for reasons pertaining to safety issues. The vaccine familiarity score was 10.79 ± 1.4, which significantly differed among the study disciplines (p < 0.001). The mean of the total attitude score was 14.95 ± 1.5, with no significant difference among demographics being noted. The mean of the total religious beliefs score was 24.29 ± 2.8 and significantly differed based on gender (p = 0.040) and study disciplines (p < 0.001). The current findings showed that the participants were familiar with vaccines and had generally positive attitudes and positive religious beliefs toward vaccination; thus, one can expect that their inclusion in immunization campaigns will generate positive outcomes of the immunization program. Although the current research reported few knowledge gaps, these may be handled with the introduction of a specialized immunization course at an undergraduate level.
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Samel-Kowalik P, Jankowski M, Lisiecka-Biełanowicz M, Ostrowska A, Gujski M, Kobuszewski B, Pinkas J, Raciborski F. Factors Associated with Attitudes towards Seasonal Influenza Vaccination in Poland: A Nationwide Cross-Sectional Survey in 2020. Vaccines (Basel) 2021; 9:vaccines9111336. [PMID: 34835267 PMCID: PMC8620474 DOI: 10.3390/vaccines9111336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022] Open
Abstract
We aimed to assess attitudes towards the influenza vaccine and factors associated with a willingness to vaccinate against seasonal influenza in Poland during the COVID-19 pandemic (flu season 2020/2021). This cross-sectional questionnaire-based study was carried out between 5 and 15 November 2020 on a representative nationwide sample of 1052 individuals aged 18+ in Poland. Of the respondents, 5.5% (95% CI: 4.3-7.0%) declared that they had already got vaccinated against influenza and 13.4% (95% CI: 11.4-15.6%) declared a willingness to vaccinate against influenza during the 2020/2021 season. Out of nine different factors analyzed in this study, only three were significantly associated with attitudes towards influenza vaccination. Participants aged 75 years and over (OR = 5.82; 95% CI: 2.63-12.85), as well as participants aged 60-74 years (OR = 2.43; 95% CI: 1.30-4.54), compared to those aged 19-29, had significantly higher odds of having a positive attitude towards seasonal influenza vaccination. Respondents who define themselves as completely religious unbelievers (OR = 4.34; 95% CI: 1.79-10.55), as well as Internet users (OR = 2.12; 95% CI: 1.30-3.47), had higher odds of having a positive attitude towards influenza vaccination. Despite the COVID-19 pandemic, the percentage of adults in Poland who already got vaccinated or declared a willingness to vaccinate against influenza remains low. This also applies to high-risk groups.
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Affiliation(s)
- Piotr Samel-Kowalik
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.S.-K.); (M.L.-B.); (F.R.)
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (A.O.); (B.K.); (J.P.)
- Correspondence:
| | - Mira Lisiecka-Biełanowicz
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.S.-K.); (M.L.-B.); (F.R.)
| | - Aurelia Ostrowska
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (A.O.); (B.K.); (J.P.)
| | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Bartosz Kobuszewski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (A.O.); (B.K.); (J.P.)
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland; (A.O.); (B.K.); (J.P.)
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland; (P.S.-K.); (M.L.-B.); (F.R.)
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Adeyanju GC, Sprengholz P, Betsch C, Essoh TA. Caregivers' Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi. Vaccines (Basel) 2021; 9:vaccines9111231. [PMID: 34835162 PMCID: PMC8623298 DOI: 10.3390/vaccines9111231] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/06/2021] [Accepted: 10/20/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors. Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief. Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.
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Affiliation(s)
- Gbadebo Collins Adeyanju
- Psychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany; (P.S.); (C.B.)
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
- Correspondence: ; Tel.: +49-152-1638-1976
| | - Philipp Sprengholz
- Psychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany; (P.S.); (C.B.)
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
| | - Cornelia Betsch
- Psychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany; (P.S.); (C.B.)
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
| | - Tene-Alima Essoh
- Agence de Médecine Préventive, Regional Directorate for Africa, Abidjan 08 BP 660, Côte d’Ivoire;
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Francis MR, Nuorti JP, Lumme-Sandt K, Kompithra RZ, Balraj V, Kang G, Mohan VR. Vaccination coverage and the factors influencing routine childhood vaccination uptake among communities experiencing disadvantage in Vellore, southern India: a mixed-methods study. BMC Public Health 2021; 21:1807. [PMID: 34620139 PMCID: PMC8499461 DOI: 10.1186/s12889-021-11881-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In 2015, the Vellore district in southern India was selected for intensified routine immunization, targeting children from communities experiencing disadvantage such as migrant, tribal, and other hard-to-reach groups. This mixed-methods study was conducted to assess routine immunization coverage and the factors influencing childhood vaccination uptake among these communities in Vellore. METHODS We conducted a cross-sectional household survey (n = 100) and six focus group discussions (n = 43) among parents of children aged 12-23 months from the known communities experiencing disadvantage in Vellore during 2017 and 2018. Multivariate logistic regression was conducted to examine associations between the parental characteristics and children's vaccination status in the household survey data; the qualitative discussions were analyzed by using the (previously published) "5As" taxonomy for the determinants of vaccine uptake. RESULTS In the household survey, the proportions of fully vaccinated children were 65% (95% CI: 53-76%) and 77% (95% CI: 58-88%) based on information from vaccination cards or parental recall and vaccination cards alone, respectively. Children whose mothers were wage earners [Adjusted prevalence odds ratio (aPOR): 0.21, 95% CI = 0.07-0.64], or salaried/small business owners [aPOR: 0.18, 95% CI = 0.04-0.73] were less likely to be fully vaccinated than children who had homemakers mothers. In the focus group discussions, parents identified difficulties in accessing routine immunization when travelling for work and showed knowledge gaps regarding the benefits and risks of vaccination, and fears surrounding certain vaccines due to negative news reports and common side-effects following childhood vaccination. CONCLUSIONS Vaccination coverage among children from the surveyed communities in Vellore was suboptimal. Our findings suggest the need to target children from Narikuravar families and conduct periodic community-based health education campaigns to improve parental awareness about and trust in childhood vaccines among the communities experiencing disadvantage in Vellore.
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Affiliation(s)
- Mark Rohit Francis
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - J Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Infectious Diseases and Vaccines Unit, Department of Health Protection, National Institute for Health and Welfare, Helsinki, Finland
| | - Kirsi Lumme-Sandt
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Rajeev Zachariah Kompithra
- Well Baby Immunization Clinic, Department of Pediatrics Unit - I, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinohar Balraj
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Venkata Raghava Mohan
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India.
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Charani E, Mendelson M, Ashiru-Oredope D, Hutchinson E, Kaur M, McKee M, Mpundu M, Price JR, Shafiq N, Holmes A. Navigating sociocultural disparities in relation to infection and antibiotic resistance-the need for an intersectional approach. JAC Antimicrob Resist 2021; 3:dlab123. [PMID: 34604747 PMCID: PMC8485076 DOI: 10.1093/jacamr/dlab123] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
One of the key drivers of antibiotic resistance (ABR) and drug-resistant bacterial infections is the misuse and overuse of antibiotics in human populations. Infection management and antibiotic decision-making are multifactorial, complex processes influenced by context and involving many actors. Social constructs including race, ethnicity, gender identity and cultural and religious practices as well as migration status and geography influence health. Infection and ABR are also affected by these external drivers in individuals and populations leading to stratified health outcomes. These drivers compromise the capacity and resources of healthcare services already over-burdened with drug-resistant infections. In this review we consider the current evidence and call for a need to broaden the study of culture and power dynamics in healthcare through investigation of relative power, hierarchies and sociocultural constructs including structures, race, caste, social class and gender identity as predictors of health-providing and health-seeking behaviours. This approach will facilitate a more sustainable means of addressing the threat of ABR and identify vulnerable groups ensuring greater inclusivity in decision-making. At an individual level, investigating how social constructs and gender hierarchies impact clinical team interactions, communication and decision-making in infection management and the role of the patient and carers will support better engagement to optimize behaviours. How people of different race, class and gender identity seek, experience and provide healthcare for bacterial infections and use antibiotics needs to be better understood in order to facilitate inclusivity of marginalized groups in decision-making and policy.
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Affiliation(s)
- Esmita Charani
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
- Corresponding author. E-mail:
| | - Marc Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | | | | | - Manmeet Kaur
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, UK
| | - Mirfin Mpundu
- International Centre for Antimicrobial Resistance Solutions, Lusaka, Zambia
| | - James R Price
- Imperial College Healthcare NHS Trust, Department of Infectious Diseases, London, UK
| | - Nusrat Shafiq
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Alison Holmes
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
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Kaufman J, Tuckerman J, Bonner C, Durrheim DN, Costa D, Trevena L, Thomas S, Danchin M. Parent-level barriers to uptake of childhood vaccination: a global overview of systematic reviews. BMJ Glob Health 2021; 6:bmjgh-2021-006860. [PMID: 34580071 PMCID: PMC8477248 DOI: 10.1136/bmjgh-2021-006860] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/09/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Understanding barriers to childhood vaccination is crucial to inform effective interventions for maximising uptake. Published systematic reviews include different primary studies, producing varying lists of barriers. To make sense of this diverse body of literature, a comprehensive level of summary and synthesis is necessary. This overview of systematic reviews maps all potential parent-level barriers to childhood vaccination identified in systematic reviews. It synthesises these into a conceptual framework to inform development of a vaccine barriers assessment tool. METHODS We applied Joanna Briggs methodology, searching the Epistemonikos review database and reference lists of included reviews to June 2020. Systematic reviews of qualitative or quantitative data on parent-level barriers to routine vaccination in preschool-aged children were included. Reviews addressing influenza, reporting non-modifiable determinants or reporting barriers not relevant to parents were excluded. Where possible, we extracted review details, barrier descriptions and the number, setting and design of primary studies. Two authors independently screened search results and inductively coded barrier descriptions. RESULTS We screened 464 papers, identifying 30 relevant reviews with minimal overlap. Fourteen reviews included qualitative and quantitative primary studies, seven included quantitative and seven included qualitative studies only. Two did not report included study designs. Two-thirds of reviews (n=20; 67%) only included primary studies from high-income countries. We extracted 573 barrier descriptions and inductively coded these into 64 unique barriers in six overarching categories: (1) Access, (2) Clinic or Health System Barriers, (3) Concerns and Beliefs, (4) Health Perceptions and Experiences, (5) Knowledge and Information and (6) Social or Family Influence. CONCLUSIONS A global overview of systematic reviews of parent-level barriers to childhood vaccine uptake identified 64 barriers to inform development of a new comprehensive survey instrument. This instrument will assess both access and acceptance barriers to more accurately diagnose the reasons for under-vaccination in children in different settings.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia .,Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Tuckerman
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carissa Bonner
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - David N Durrheim
- Health Protection, Hunter New England Health, Wallsend, New South Wales, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Daniel Costa
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Lyndal Trevena
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
| | - Susan Thomas
- Health Protection, Hunter New England Health, Wallsend, New South Wales, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Chen H, Li X, Gao J, Liu X, Mao Y, Wang R, Zheng P, Xiao Q, Jia Y, Fu H, Dai J. Health Belief Model Perspective on the Control of COVID-19 Vaccine Hesitancy and the Promotion of Vaccination in China: Web-Based Cross-sectional Study. J Med Internet Res 2021; 23:e29329. [PMID: 34280115 PMCID: PMC8425399 DOI: 10.2196/29329] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/26/2021] [Accepted: 07/12/2021] [Indexed: 01/16/2023] Open
Abstract
Background The control of vaccine hesitancy and the promotion of vaccination are key protective measures against COVID-19. Objective This study assesses the prevalence of vaccine hesitancy and the vaccination rate and examines the association between factors of the health belief model (HBM) and vaccination. Methods A convenience sample of 2531 valid participants from 31 provinces and autonomous regions of mainland China were enrolled in this online survey study from January 1 to 24, 2021. Multivariable logistic regression was used to identify the associations of the vaccination rate and HBM factors with the prevalence of vaccine hesitancy after other covariates were controlled. Results The prevalence of vaccine hesitancy was 44.3% (95% CI 42.3%-46.2%), and the vaccination rate was 10.4% (9.2%-11.6%). The factors that directly promoted vaccination behavior were a lack of vaccine hesitancy (odds ratio [OR] 7.75, 95% CI 5.03-11.93), agreement with recommendations from friends or family for vaccination (OR 3.11, 95% CI 1.75-5.52), and absence of perceived barriers to COVID-19 vaccination (OR 0.51, 95% CI 0.35-0.75). The factors that were directly associated with a higher vaccine hesitancy rate were a high level of perceived barriers (OR 1.63, 95% CI 1.36-1.95) and perceived benefits (OR 0.51, 95% CI 0.32-0.79). A mediating effect of self-efficacy, influenced by perceived barriers (standardized structure coefficient [SSC]=−0.71, P<.001), perceived benefits (SSC=0.58, P<.001), agreement with recommendations from authorities (SSC=0.27, P<.001), and agreement with recommendations from friends or family (SSC=0.31, P<.001), was negatively associated with vaccination (SSC=−0.45, P<.001) via vaccine hesitancy (SSC=−0.32, P<.001). Conclusions It may be possible to increase the vaccination rate by reducing vaccine hesitancy and perceived barriers to vaccination and by encouraging volunteers to advocate for vaccination to their friends and family members. It is also important to reduce vaccine hesitancy by enhancing self-efficacy for vaccination, due to its crucial mediating function.
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Affiliation(s)
- Hao Chen
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Xiaomei Li
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoxi Liu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Yimeng Mao
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Ruru Wang
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Qianyi Xiao
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Yingnan Jia
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Hua Fu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Junming Dai
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
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Khetsuriani N, Mosina L, Van Damme P, Mozalevskis A, Datta S, Tohme RA. Progress Toward Hepatitis B Control - World Health Organization European Region, 2016-2019. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1029-1035. [PMID: 34324482 PMCID: PMC8323554 DOI: 10.15585/mmwr.mm7030a1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Cooper S, van Rooyen H, Wiysonge CS. COVID-19 vaccine hesitancy in South Africa: how can we maximize uptake of COVID-19 vaccines? Expert Rev Vaccines 2021; 20:921-933. [PMID: 34252336 DOI: 10.1080/14760584.2021.1949291] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Acceptance of COVID-19 vaccines is critical to personal health, protecting vulnerable populations, reopening socio-economic life, and achieving population health and safety through immunity. The primary aim of this review was to investigate the extent and determinants of COVID-19 vaccine hesitancy in South Africa to inform the development of strategies to address it. A secondary aim was to enhance understandings of and responses to vaccine hesitancy more generally in South Africa, with potential positive effect on vaccination uptake during and beyond the COVID-19 pandemic.Areas covered: We reviewed the findings from surveys conducted in South Africa from February 2020 to March 2021 that investigated acceptance of COVID-19 vaccines. Surveys were identified through searching electronic databases of peer-reviewed and gray literature and contacting experts.Expert opinion: The review reveals the inherently social nature of COVID-19 vaccine hesitancy in South Africa, potentially influenced by age, race, education, politics, geographical location, and employment. Along with the provision of information, COVID-19 vaccine communication strategies need to form part of broader trust-building measures that focus on relationships, transparency, participation, and justice. The pandemic also provides a unique opportunity to positively intervene and reduce vaccine hesitancy trends more generally in South Africa and potentially elsewhere.
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Affiliation(s)
- Sara Cooper
- Cochrane South Africa, South African Medical Research Council Francie van Zijl Drive,Parow Valley Cape Town 7501, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Heidi van Rooyen
- The Impact Centre, Human Sciences Research, Parow, South Africa.,SAMRC-Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council Francie van Zijl Drive,Parow Valley Cape Town 7501, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Department of Global Health, Stellenbosch University, Cape Town, South Africa
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Arat A, Moore HC, Goldfeld S, Östberg V, Sheppeard V, Gidding HF. Childhood vaccination coverage in Australia: an equity perspective. BMC Public Health 2021; 21:1337. [PMID: 34229652 PMCID: PMC8261950 DOI: 10.1186/s12889-021-11345-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states. RESULTS Vaccination coverage was 3-4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively). CONCLUSION Despite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.
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Affiliation(s)
- Arzu Arat
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institute, Stockholm, Sweden.
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Sharon Goldfeld
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Vicky Sheppeard
- Communicable Diseases Branch, Health Protection NSW, North Sydney, NSW, Australia
| | - Heather F Gidding
- Women and Babies Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia
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Antivaccine Movement and COVID-19 Negationism: A Content Analysis of Spanish-Written Messages on Twitter. Vaccines (Basel) 2021; 9:vaccines9060656. [PMID: 34203946 PMCID: PMC8232574 DOI: 10.3390/vaccines9060656] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 12/27/2022] Open
Abstract
During the COVID-19 pandemic, different conspiracies have risen, with the most dangerous being those focusing on vaccines. Today, there exists a social media movement focused on destroying the credibility of vaccines and trying to convince people to ignore the advice of governments and health organizations on vaccination. Our aim was to analyze a COVID-19 antivaccination message campaign on Twitter that uses Spanish as the main language, to find the key elements in their communication strategy. Twitter data were retrieved from 14 to 28 December using NodeXL software. We analyzed tweets in Spanish, focusing on influential users, most influential tweets, and content analysis of tweets. The results revealed ordinary citizens who 'offer the truth' as the most important profile in this network. The content analysis showed antivaccine tweets (31.05%) as the most frequent. The analysis of anti-COVID19 tweets showed that attacks against vaccine safety were the most important (79.87%) but we detected a new kind of message presenting the vaccine as a means of manipulating the human genetic code (8.1%). We concluded that the antivaccine movement and its tenets have great influence in the COVID-19 negationist movement. We observed a new topic in COVID-19 vaccine hoaxes that must be considered in our fight against misinformation.
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Recio-Román A, Recio-Menéndez M, Román-González MV. Global Vaccine Hesitancy Segmentation: A Cross-European Approach. Vaccines (Basel) 2021; 9:617. [PMID: 34201130 PMCID: PMC8227608 DOI: 10.3390/vaccines9060617] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022] Open
Abstract
Vaccine-preventable diseases are global mainly in a globalized world that is characterized by a continuous movement of people and goods across countries. Vaccine hesitancy, the reluctance or refusal to vaccinate despite the availability of vaccines, is rising worldwide. What if the problem of vaccine hesitancy could be most effectively managed when treated globally rather than on a national or regional basis? What if a global vaccine-hesitant segment exists and the differences among countries are not so significant? Based on the Global Marketing Strategy paradigm, this paper shows that seven different cross-European segments exist based on the beliefs, attitudes, and behaviors collected in 28 European countries. These pan-European segments are differentiable (people in those segments have similar characteristics that are visibly dissimilar from the ones in other segments) and actionable (organizations would be able to propose interventions to the hesitant segments based on their profiles). With segmentation being the starting point of many public health intervention strategies for avoiding vaccine-hesitancy, the results recommend moderating the full-adaptation strategy that follows the "context matters" principle suggested by several political and public health international organizations. Embracing a more standardized strategy will allow the development of better services and strategies that support and enable desirable vaccination behaviors.
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Affiliation(s)
- Almudena Recio-Román
- Department of Economy and Business, University of Almería, Carretera de Sacramento s/n, 04120 Almería, Spain; (M.R.-M.); (M.V.R.-G.)
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Popper-Giveon A, Keshet Y. Non-Vaccination Stage Model (NVST): The decision-making process among Israeli ultra-orthodox Jewish parents. Health (London) 2021; 26:777-792. [PMID: 34002627 DOI: 10.1177/1363459320988884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although vaccination uptake is high in most countries, pockets of suboptimal coverage remain, such as those observed among ultra-orthodox Jews in Israel and elsewhere, posing a threat to both individual and public immunity. Drawing on the Precaution Adoption Process Model (PAPM), this study proposes a Non-Vaccination Stage Model (NVSM) to analyze the decision-making process among Non-Vaccinating Parents (NVPs), focusing on the ultra-orthodox Jewish population of Israel. In-depth interviews were conducted with 10 Israeli ultra-orthodox Jewish NVPs (mothers). The interviews revealed five stages in the participants' decision-making process: Being good mothers who vaccinate their children; Emergence of doubts regarding the risks of vaccination; Personal vaccination policy-hesitancy concerning vaccination; Decision not to vaccinate; Confirmation signs of what participants perceive as a wise decision. NVSM can help understand parents who consider non-vaccination to be healthier behavior and explore the various stages of their decision-making process. Differentiating among the various stages of NVPs' decision-making processes enables application of different intervention approaches by policymakers and healthcare practitioners.
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Cerda AA, García LY. Hesitation and Refusal Factors in Individuals' Decision-Making Processes Regarding a Coronavirus Disease 2019 Vaccination. Front Public Health 2021; 9:626852. [PMID: 33968880 PMCID: PMC8096991 DOI: 10.3389/fpubh.2021.626852] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/23/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures-and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, information will be needed to support a potential campaign to promote vaccination. Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects. Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile. Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies. Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
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Affiliation(s)
| | - Leidy Y. García
- Faculty of Economics and Business, University of Talca, Talca, Chile
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Cross-sectional analysis of COVID-19 vaccine intention, perceptions and hesitancy across Latin America and the Caribbean. Travel Med Infect Dis 2021; 41:102059. [PMID: 33848692 PMCID: PMC8063600 DOI: 10.1016/j.tmaid.2021.102059] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/22/2022]
Abstract
Background Determinants of vaccine acceptance are multifactorial, complex, and in most cases, context-dependent. We determined the prevalence of COVID-19 vaccination intention (VI) and fear of its adverse effects (FAE) as well as their associated factors in Latin America and the Caribbean (LAC). Methods We conducted a secondary cross-sectional analysis of a database collected by the University of Maryland and Facebook. We included participants aged 18 and over from LAC surveyed, January 15 to February 1, 2021. We evaluated VI, FAE, sociodemographic characteristics, COVID-19 symptomatology, compliance with community mitigation strategies, food and economic insecurity, mental health evaluation and the influence in VI when recommended by different stakeholders. We calculated crude and adjusted prevalence ratios with their 95%CIs. Results We analyzed 472,521 responses by Latin American adults, finding a VI and FAE prevalence of 80.0% and 81.2%, respectively. We found that female and non-binary genders were associated with a lower probability of VI and a higher probability of FAE. Besides, living in a town, village or rural area and economic insecurity was associated with a higher FAE probability. The fears of becoming seriously ill, a family member becoming seriously ill from COVID-19 and having depressive symptoms were associated with a higher probability of VI and FAE. Conclusion Eight out of 10 adults in LAC have VI and FAE. The factors identified are useful for the development of communication strategies to reduce FAE frequency. It is necessary to guarantee mass vaccination and support the return of economic activities.
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Matos CCDSA, Gonçalves BA, Couto MT. Vaccine hesitancy in the global south: Towards a critical perspective on global health. Glob Public Health 2021; 17:1087-1098. [PMID: 33843459 DOI: 10.1080/17441692.2021.1912138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The complex phenomenon of vaccine hesitancy has been causing increasing global concern. This systematic review aims at analysing the state of art of scientific literature concerning vaccine hesitancy in Latin America and Africa, observing if: (i) they use the same research trends as the global North; and (ii) the parameters recommended by the World Health Organization (WHO) and taken from the experience of the global North are adequate to the Global South's context. This review analyses empirical, qualitative, quantitative, or mixed-study publications, from 2015 to 2020, available at five different databases. The studies produced in the Global South bring up important context-specific issues, such as issues of access (that are not included in the WHO's definition of vaccine hesitancy), cultural and religious issues, reactions to governments, reactions to recent episodes of vaccine tests on populations, and reactions to past of colonial violence. Initiatives to understand the phenomenon based on methodological and conceptual frameworks from the global North alone can cause wrongful conclusions.
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